Introduction, please read closely.

General Practices that are NOT testing for COVID-19 in the SEMPHN region can request using this survey if they have sought and are unable to secure commercial supply:
- Level 1 Surgical masks
-  Goggles
- P2/N95 masks (only for respiratory assessment)


Supply is strictly limited, so South Eastern Melbourne PHN will allocate accordingly and cannot guarantee stock will be available.

South Eastern Melbourne PHN can only supply to practices within our catchment. If needed please check the PHN Locator online.

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* 1. General Practice name

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* 2. Address Street and number. Line 1 (max 30 characters)

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* 3. Address Street and number. line 2 (max 30 characters)

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* 4. Address Suburb

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* 5. Address Postcode

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* 6. Requesting Name

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* 7. Phone number

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* 8. Email

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* 9. Position

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* 10. What types of PPE are you requesting? (tick those you cannot secure  commercial supply for)

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* 11. You must confirm that your practice  has, despite your best efforts, been unable to commercially secure the PPE requested.

Thank you for your request. SEMPHN will seek to respond by email within 3 weekdays.
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